How many times do you get up in the night to pee? And is it easy to get back to sleep after?

Fariya and I have helped hundreds of women improve their breathing, which has resulted in better sleep, calmer bladders, and greater focus. Today, we’re going to explain the connection, provide accessible strategies, and get you on the road to greater energy for what you love. So let’s go!

Welcome to episode number 38 of the Midlife Reset Podcast. I’m your host, a yoga therapist, mindfulness coach, and your trusted friend when you need advice about aging strong holistically.

Please welcome my guest, Fariya Doctor. I have been a client of Fariya’s—she’s amazing and super smart. She is a registered massage therapist and a long-time practitioner of Feldenkrais Movement Therapy. Together, we’ve prepared a unique program to address a problem that plagues so many midlife women: getting up to pee three, four, five times a night. It is so exhausting.

I’d like to turn the presentation now over to Fariya as she shares some science and practical tools around breathing, bladder issues, and better sleep.

Fariya: Thank you very much. One of the reasons I love this topic is because it’s so powerful and so changeable. People don’t realize how quickly they can change their sleep outcomes.

As a Feldenkrais practitioner, I focus on function—how to optimize function is a big passion of mine. Being a Buteyko breathing instructor has helped me understand the science behind improving breathing so you can sleep better. One aspect is your breathing pattern.

One thing people often don’t realize is that they may have an underlying breathing problem. They’re destabilized in their breathing during the day, which makes it harder to slow down at night and stay asleep.

A breathing pattern disorder means you’re breathing more than you need. The definition includes patterns of over-breathing where the depth and rate of breath exceed your body’s needs. It’s not necessarily a panic attack—it might simply be breathing more than 20 breaths per minute, often through the mouth.

Mouth-breathing during the day creates short, quick breaths that alter your internal chemistry—the balance between carbon dioxide and oxygen. Interestingly, the brain monitors carbon dioxide levels, not oxygen, because oxygen saturation is usually fine unless there is a lung disorder. When carbon dioxide levels get too low, we can feel anxious, get headaches, experience chest tightness, cold extremities, tight muscles, aggravated allergies, altered hormone cycles, and pins and needles.

The cool thing is that this can be reversed quickly by slowing your breathing, reducing volume, and reducing effort.

How does this affect our bladder? A key hormone involved is vasopressin. Vasopressin rises in the evening and during sleep. Its job is to manage fluids in the body, because even though we’re resting, we lose fluid through respiration—more so if mouth-breathing, which dries us out.

Vasopressin keeps fluids cycling through the kidneys and prevents the bladder from filling at night. But if vasopressin levels drop due to destabilized breathing, the bladder fills during the night, waking us up.

(See diagram in video) This shows the bladder sitting low in the pelvis, beneath the uterus and sigmoid colon. When the bladder fills, it puts pressure in the pelvis, triggering nighttime wake-ups.

Most people know the basic sleep hygiene advice—stop drinking fluids in the evening. But if breathing is off, vasopressin stays low and nighttime wake-ups continue.

There are many useful tools to improve this—breathing through the nose at night, mouth tape, mouth guards, and learning to maximize nasal airways.

Some helpful books include The Oxygen Advantage by Patrick McKeown and Breath by James Nestor, both powerful introductions to the science of breathing. I also teach courses and have many free YouTube videos, including “Improve Nasal Breathing, Improve Your Life,” covering how to establish proper nasal breathing for overall health.

Cheryl: And with the hormone changes that many people completely miss, in perimenopause and menopause, progesterone and estrogen levels drop. But vasopressin also changes, and breathing intimately impacts all hormone balance.

Let’s now talk about getting back to sleep, because that part is so important. Here’s why sleep is getting worse: hormonal changes shift the body’s relaxation chemistry. Hormones tell you when to pee, when you’re allowed to sleep, when you’re hungry, and even when you can get angry. This is why sleep, mood, and energy feel unpredictable in midlife.

Many of us wish for a solid eight hours of sleep, but this isn’t necessary—or even realistic. Sleep has stages: the early relaxed stage, light sleep, slow-wave deep sleep for healing and recovery, and REM sleep when dreams happen and the brain is highly active. These cycles repeat through the night.

As hormones shift in midlife, sleep cycles become shorter, meaning you experience more cycles per night and therefore more opportunities to wake up at the end of REM. This isn’t bad—it’s normal. Understanding this reduces panic during nighttime wake-ups.

This is where non-sleep deep rest (NSDR) becomes a superpower. When we wake, we often panic—worrying about the next day, feeling broken, or angry at ourselves. But NSDR intentionally places the brain into a restorative state without actually sleeping. It restores energy, calms hormones, and primes learning. One hour of NSDR may equal four hours of a regular sleep cycle.

So here are the actual strategies:

1. At a 3 a.m. wake-up, stay calm.Don’t fight wakefulness. Breathe. Remind yourself another sleep cycle is coming. Apps like Insight Timer offer many free sleep meditations. Avoid getting upset—that hormonal spike makes it harder to return to sleep.

2. Eye relaxation technique.Lie comfortably with your elbows supported. Cup your palms gently over your closed eyes without pressing. Feel the warmth soothing the muscles. Then slowly move your eyes left to right a few times. Then up and down. Then diagonally in both directions. Finally, slow circles in both directions, keeping your head still and moving only your eyes. This slows the nervous system and helps shift you into relaxation.

* Backwards Breathing. The next technique you can try in the middle of the night is what I call backwards breath. It’s a version of counting sheep, I guess—like “99 bottles of beer on the wall”—but with a specific purpose.

A lot of studies show that counting from 31 down to 0 is adequate to get people back to sleep. For me, because I’m a real Type A, high-need person, I start at 100 and go backwards.

The technique is simple:You breathe in and breathe out at your normal rate, your normal way, in and out through the nose, as Freya taught us. And you count: 100 in, 100 out. 99 in, 99 out. 98 in, 98 out, and so on, all the way down to zero.

Most of the time, if you don’t fall asleep, you’ll get distracted. Your good friend, the brain, will try to get you all revved up about something. The rule is: if you get distracted, you go back and start at 100 again.

And some nights, you might go back to 100 a hundred times. But the reason this works is that counting backwards requires a different part of your brain. It pulls you out of the worry-anxiety part that’s keeping you awake and into a more logical part—the part that “reads the room” and knows this is sleep time. It’s like talking sense to yourself.

* Restorative Yoga in Bed. I’m not sure if you’ve ever had the bliss of a full restorative yoga class, but I highly recommend it.

You can adapt many of the postures and do them right in bed. I sleep with three pillows—that’s another podcast—but I take those pillows and give myself supported child’s pose, supported rotated child’s pose, legs up the pillows (so, an elevated legs position). I do reclining twists propped up with pillows, butterfly legs propped up with pillows.

All of these poses may or may not be familiar to you, but I have resources on YouTube. Just message me and I’m happy to show you photos or send you videos, because restorative yoga is such a wonderful practice for everyone. I do this right in bed, underneath my covers, so I stay warm.

And a lot of times, I actually fall back asleep in one of those restorative poses. And yes, I have a partner right beside me—he’s still snoring. I really need him to listen to Freya’s talk about not mouth-breathing, because he’s got all the things she said would happen if you mouth-breathe. I’ll make sure he sees the replay.

You can get the audio and video guidance for the strategies I just talked about, as well as further tips for how to set yourself up with a better morning routine, in my Sleep Solutions course.

When your nervous system feels safe, my friends, your body can heal. And when your body heals, your brain can learn. And when your brain learns, midlife becomes a season of possibility—not decline.

Fariya, thank you so much for joining me today.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit cherylgordonyt.substack.com